|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$281.59
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
76100068
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$603.96 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: Aetna Medicare |
$389.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.06
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Complete |
$219.30
|
| Rate for Payer: BCBS MAPPO |
$389.65
|
| Rate for Payer: BCBS Trust/PPO |
$230.59
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: BCN Medicare Advantage |
$389.65
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$264.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$389.65
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Humana Choice PPO Medicare |
$389.65
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Mclaren Medicaid |
$208.85
|
| Rate for Payer: Mclaren Medicare |
$389.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.13
|
| Rate for Payer: Meridian Medicaid |
$219.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: PACE Medicare |
$370.17
|
| Rate for Payer: PACE SWMI |
$389.65
|
| Rate for Payer: PHP Commercial |
$428.62
|
| Rate for Payer: PHP Medicaid |
$208.85
|
| Rate for Payer: PHP Medicare Advantage |
$389.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$246.73
|
| Rate for Payer: Priority Health Medicare |
$389.65
|
| Rate for Payer: Priority Health Narrow Network |
$197.39
|
| Rate for Payer: Railroad Medicare Medicare |
$389.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$389.65
|
| Rate for Payer: UHC Exchange |
$603.96
|
| Rate for Payer: UHC Medicare Advantage |
$389.65
|
| Rate for Payer: UHCCP DNSP |
$389.65
|
| Rate for Payer: UHCCP Medicaid |
$208.85
|
| Rate for Payer: VA VA |
$389.65
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$459.55
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$298.71 |
| Max. Negotiated Rate |
$459.55 |
| Rate for Payer: Aetna Commercial |
$413.60
|
| Rate for Payer: ASR ASR |
$445.76
|
| Rate for Payer: ASR Commercial |
$445.76
|
| Rate for Payer: BCBS Trust/PPO |
$374.49
|
| Rate for Payer: BCN Commercial |
$356.29
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$431.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Healthscope Commercial |
$459.55
|
| Rate for Payer: Healthscope Whirlpool |
$445.76
|
| Rate for Payer: Mclaren Commercial |
$413.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: Nomi Health Commercial |
$376.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$404.40
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
IP
|
$281.59
|
|
|
Service Code
|
CPT 10120
|
| Hospital Charge Code |
76100068
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.03 |
| Max. Negotiated Rate |
$281.59 |
| Rate for Payer: Aetna Commercial |
$253.43
|
| Rate for Payer: ASR ASR |
$273.14
|
| Rate for Payer: ASR Commercial |
$273.14
|
| Rate for Payer: BCBS Trust/PPO |
$229.47
|
| Rate for Payer: BCN Commercial |
$218.32
|
| Rate for Payer: Cash Price |
$225.27
|
| Rate for Payer: Cofinity Commercial |
$264.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.27
|
| Rate for Payer: Healthscope Commercial |
$281.59
|
| Rate for Payer: Healthscope Whirlpool |
$273.14
|
| Rate for Payer: Mclaren Commercial |
$253.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.35
|
| Rate for Payer: Nomi Health Commercial |
$230.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$247.80
|
|
|
HC FOREIGN BODY REMOVAL
|
Facility
|
OP
|
$459.55
|
|
| Hospital Charge Code |
45000042
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$183.82 |
| Max. Negotiated Rate |
$459.55 |
| Rate for Payer: Aetna Commercial |
$413.60
|
| Rate for Payer: Aetna Medicare |
$229.78
|
| Rate for Payer: ASR ASR |
$445.76
|
| Rate for Payer: ASR Commercial |
$445.76
|
| Rate for Payer: BCBS Complete |
$183.82
|
| Rate for Payer: BCBS Trust/PPO |
$376.33
|
| Rate for Payer: BCN Commercial |
$356.29
|
| Rate for Payer: Cash Price |
$367.64
|
| Rate for Payer: Cofinity Commercial |
$431.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$367.64
|
| Rate for Payer: Healthscope Commercial |
$459.55
|
| Rate for Payer: Healthscope Whirlpool |
$445.76
|
| Rate for Payer: Mclaren Commercial |
$413.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$390.62
|
| Rate for Payer: Nomi Health Commercial |
$376.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$298.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$402.66
|
| Rate for Payer: Priority Health Narrow Network |
$322.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$404.40
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
IP
|
$216.75
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$140.89 |
| Max. Negotiated Rate |
$216.75 |
| Rate for Payer: Aetna Commercial |
$195.07
|
| Rate for Payer: ASR ASR |
$210.25
|
| Rate for Payer: ASR Commercial |
$210.25
|
| Rate for Payer: BCBS Trust/PPO |
$176.63
|
| Rate for Payer: BCN Commercial |
$168.05
|
| Rate for Payer: Cash Price |
$173.40
|
| Rate for Payer: Cofinity Commercial |
$203.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.40
|
| Rate for Payer: Healthscope Commercial |
$216.75
|
| Rate for Payer: Healthscope Whirlpool |
$210.25
|
| Rate for Payer: Mclaren Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.24
|
| Rate for Payer: Nomi Health Commercial |
$177.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$190.74
|
|
|
HC FOREIGN BODY REMOVAL EAR
|
Facility
|
OP
|
$216.75
|
|
|
Service Code
|
CPT 69200
|
| Hospital Charge Code |
45000060
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$216.75 |
| Rate for Payer: Aetna Commercial |
$195.07
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$210.25
|
| Rate for Payer: ASR Commercial |
$210.25
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$177.50
|
| Rate for Payer: BCN Commercial |
$168.05
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$173.40
|
| Rate for Payer: Cash Price |
$173.40
|
| Rate for Payer: Cofinity Commercial |
$203.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$216.75
|
| Rate for Payer: Healthscope Whirlpool |
$210.25
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.24
|
| Rate for Payer: Nomi Health Commercial |
$177.74
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$189.92
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$151.94
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$190.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
IP
|
$1,176.05
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$1,176.05 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Trust/PPO |
$958.36
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
|
|
HC FOREIGN BODY REMOVAL MUSCLE OR TENDON SHEATH SIMPLE
|
Facility
|
OP
|
$1,176.05
|
|
|
Service Code
|
CPT 20520
|
| Hospital Charge Code |
76100133
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$764.43 |
| Max. Negotiated Rate |
$2,449.29 |
| Rate for Payer: Aetna Commercial |
$1,058.44
|
| Rate for Payer: Aetna Medicare |
$1,580.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: ASR ASR |
$1,140.77
|
| Rate for Payer: ASR Commercial |
$1,140.77
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCBS Trust/PPO |
$963.07
|
| Rate for Payer: BCN Commercial |
$911.79
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cash Price |
$940.84
|
| Rate for Payer: Cofinity Commercial |
$1,105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$940.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,176.05
|
| Rate for Payer: Healthscope Whirlpool |
$1,140.77
|
| Rate for Payer: Humana Choice PPO Medicare |
$1,580.19
|
| Rate for Payer: Mclaren Commercial |
$1,058.44
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$999.64
|
| Rate for Payer: Nomi Health Commercial |
$964.36
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,738.21
|
| Rate for Payer: PHP Medicaid |
$846.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$764.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,030.46
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health Narrow Network |
$824.41
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,034.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$2,449.29
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP DNSP |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: VA VA |
$1,580.19
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
OP
|
$231.65
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$67.38 |
| Max. Negotiated Rate |
$231.65 |
| Rate for Payer: Aetna Commercial |
$208.49
|
| Rate for Payer: Aetna Medicare |
$125.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.14
|
| Rate for Payer: ASR ASR |
$224.70
|
| Rate for Payer: ASR Commercial |
$224.70
|
| Rate for Payer: BCBS Complete |
$70.75
|
| Rate for Payer: BCBS MAPPO |
$125.71
|
| Rate for Payer: BCBS Trust/PPO |
$189.70
|
| Rate for Payer: BCN Commercial |
$179.60
|
| Rate for Payer: BCN Medicare Advantage |
$125.71
|
| Rate for Payer: Cash Price |
$185.32
|
| Rate for Payer: Cash Price |
$185.32
|
| Rate for Payer: Cofinity Commercial |
$217.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.71
|
| Rate for Payer: Healthscope Commercial |
$231.65
|
| Rate for Payer: Healthscope Whirlpool |
$224.70
|
| Rate for Payer: Humana Choice PPO Medicare |
$125.71
|
| Rate for Payer: Mclaren Commercial |
$208.49
|
| Rate for Payer: Mclaren Medicaid |
$67.38
|
| Rate for Payer: Mclaren Medicare |
$125.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.00
|
| Rate for Payer: Meridian Medicaid |
$70.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.90
|
| Rate for Payer: Nomi Health Commercial |
$189.95
|
| Rate for Payer: PACE Medicare |
$119.42
|
| Rate for Payer: PACE SWMI |
$125.71
|
| Rate for Payer: PHP Commercial |
$138.28
|
| Rate for Payer: PHP Medicaid |
$67.38
|
| Rate for Payer: PHP Medicare Advantage |
$125.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.97
|
| Rate for Payer: Priority Health Medicare |
$125.71
|
| Rate for Payer: Priority Health Narrow Network |
$162.39
|
| Rate for Payer: Railroad Medicare Medicare |
$125.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.71
|
| Rate for Payer: UHC Exchange |
$194.85
|
| Rate for Payer: UHC Medicare Advantage |
$125.71
|
| Rate for Payer: UHCCP DNSP |
$125.71
|
| Rate for Payer: UHCCP Medicaid |
$67.38
|
| Rate for Payer: VA VA |
$125.71
|
|
|
HC FOREIGN BODY REMOVAL NOSE
|
Facility
|
IP
|
$231.65
|
|
|
Service Code
|
CPT 30300
|
| Hospital Charge Code |
45000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$150.57 |
| Max. Negotiated Rate |
$231.65 |
| Rate for Payer: Aetna Commercial |
$208.49
|
| Rate for Payer: ASR ASR |
$224.70
|
| Rate for Payer: ASR Commercial |
$224.70
|
| Rate for Payer: BCBS Trust/PPO |
$188.77
|
| Rate for Payer: BCN Commercial |
$179.60
|
| Rate for Payer: Cash Price |
$185.32
|
| Rate for Payer: Cofinity Commercial |
$217.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$185.32
|
| Rate for Payer: Healthscope Commercial |
$231.65
|
| Rate for Payer: Healthscope Whirlpool |
$224.70
|
| Rate for Payer: Mclaren Commercial |
$208.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.90
|
| Rate for Payer: Nomi Health Commercial |
$189.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.85
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
OP
|
$3,897.02
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$4,758.02 |
| Rate for Payer: Aetna Commercial |
$3,507.32
|
| Rate for Payer: Aetna Medicare |
$3,069.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: ASR ASR |
$3,780.11
|
| Rate for Payer: ASR Commercial |
$3,780.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,191.27
|
| Rate for Payer: BCN Commercial |
$3,021.36
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,117.62
|
| Rate for Payer: Cash Price |
$3,117.62
|
| Rate for Payer: Cofinity Commercial |
$3,663.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,117.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,897.02
|
| Rate for Payer: Healthscope Whirlpool |
$3,780.11
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,069.69
|
| Rate for Payer: Mclaren Commercial |
$3,507.32
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,312.47
|
| Rate for Payer: Nomi Health Commercial |
$3,195.56
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,376.66
|
| Rate for Payer: PHP Medicaid |
$1,645.35
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,533.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,414.57
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health Narrow Network |
$2,731.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,429.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$4,758.02
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP DNSP |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: VA VA |
$3,069.69
|
|
|
HC FOREIGN BODY RETRIEV (VASC)
|
Facility
|
IP
|
$3,897.02
|
|
|
Service Code
|
CPT 37197
|
| Hospital Charge Code |
36100375
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,533.06 |
| Max. Negotiated Rate |
$3,897.02 |
| Rate for Payer: Aetna Commercial |
$3,507.32
|
| Rate for Payer: ASR ASR |
$3,780.11
|
| Rate for Payer: ASR Commercial |
$3,780.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,175.68
|
| Rate for Payer: BCN Commercial |
$3,021.36
|
| Rate for Payer: Cash Price |
$3,117.62
|
| Rate for Payer: Cofinity Commercial |
$3,663.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,117.62
|
| Rate for Payer: Healthscope Commercial |
$3,897.02
|
| Rate for Payer: Healthscope Whirlpool |
$3,780.11
|
| Rate for Payer: Mclaren Commercial |
$3,507.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,312.47
|
| Rate for Payer: Nomi Health Commercial |
$3,195.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,533.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,429.38
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
OP
|
$366.59
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$367.66 |
| Rate for Payer: Aetna Commercial |
$329.93
|
| Rate for Payer: Aetna Medicare |
$237.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: ASR ASR |
$355.59
|
| Rate for Payer: ASR Commercial |
$355.59
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCBS Trust/PPO |
$300.20
|
| Rate for Payer: BCN Commercial |
$284.22
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$293.27
|
| Rate for Payer: Cash Price |
$293.27
|
| Rate for Payer: Cofinity Commercial |
$344.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$366.59
|
| Rate for Payer: Healthscope Whirlpool |
$355.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$237.20
|
| Rate for Payer: Mclaren Commercial |
$329.93
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.60
|
| Rate for Payer: Nomi Health Commercial |
$300.60
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$260.92
|
| Rate for Payer: PHP Medicaid |
$127.14
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.21
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health Narrow Network |
$256.98
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$367.66
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP DNSP |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: VA VA |
$237.20
|
|
|
HC FORESKIN MANIP W LYSIS ADH AND STRETCH
|
Facility
|
IP
|
$366.59
|
|
|
Service Code
|
CPT 54450
|
| Hospital Charge Code |
76100269
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.28 |
| Max. Negotiated Rate |
$366.59 |
| Rate for Payer: Aetna Commercial |
$329.93
|
| Rate for Payer: ASR ASR |
$355.59
|
| Rate for Payer: ASR Commercial |
$355.59
|
| Rate for Payer: BCBS Trust/PPO |
$298.73
|
| Rate for Payer: BCN Commercial |
$284.22
|
| Rate for Payer: Cash Price |
$293.27
|
| Rate for Payer: Cofinity Commercial |
$344.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$293.27
|
| Rate for Payer: Healthscope Commercial |
$366.59
|
| Rate for Payer: Healthscope Whirlpool |
$355.59
|
| Rate for Payer: Mclaren Commercial |
$329.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$311.60
|
| Rate for Payer: Nomi Health Commercial |
$300.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$322.60
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
IP
|
$24.13
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.68 |
| Max. Negotiated Rate |
$24.13 |
| Rate for Payer: Aetna Commercial |
$21.72
|
| Rate for Payer: ASR ASR |
$23.41
|
| Rate for Payer: ASR Commercial |
$23.41
|
| Rate for Payer: BCBS Trust/PPO |
$19.66
|
| Rate for Payer: BCN Commercial |
$18.71
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$22.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Healthscope Commercial |
$24.13
|
| Rate for Payer: Healthscope Whirlpool |
$23.41
|
| Rate for Payer: Mclaren Commercial |
$21.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.51
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.23
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN
|
Facility
|
OP
|
$24.13
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200017
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$24.13 |
| Rate for Payer: Aetna Commercial |
$21.72
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$23.41
|
| Rate for Payer: ASR Commercial |
$23.41
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.76
|
| Rate for Payer: BCN Commercial |
$18.71
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cash Price |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$22.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$24.13
|
| Rate for Payer: Healthscope Whirlpool |
$23.41
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$21.72
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.51
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.14
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$16.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$21.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$35.37 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: ASR ASR |
$34.31
|
| Rate for Payer: ASR Commercial |
$34.31
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$28.96
|
| Rate for Payer: BCN Commercial |
$27.42
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$35.37
|
| Rate for Payer: Healthscope Whirlpool |
$34.31
|
| Rate for Payer: Humana Choice PPO Medicare |
$5.22
|
| Rate for Payer: Mclaren Commercial |
$31.83
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$5.74
|
| Rate for Payer: PHP Medicaid |
$2.80
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.99
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$24.79
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$8.09
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP DNSP |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: VA VA |
$5.22
|
|
|
HC FORMALDEHYDE ALLERGY SCREEN REF LAB
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200125
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$35.37 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: ASR ASR |
$34.31
|
| Rate for Payer: ASR Commercial |
$34.31
|
| Rate for Payer: BCBS Trust/PPO |
$28.82
|
| Rate for Payer: BCN Commercial |
$27.42
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$35.37
|
| Rate for Payer: Healthscope Whirlpool |
$34.31
|
| Rate for Payer: Mclaren Commercial |
$31.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.13
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
OP
|
$690.61
|
|
| Hospital Charge Code |
45000044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$276.24 |
| Max. Negotiated Rate |
$690.61 |
| Rate for Payer: Aetna Commercial |
$621.55
|
| Rate for Payer: Aetna Medicare |
$345.31
|
| Rate for Payer: ASR ASR |
$669.89
|
| Rate for Payer: ASR Commercial |
$669.89
|
| Rate for Payer: BCBS Complete |
$276.24
|
| Rate for Payer: BCBS Trust/PPO |
$565.54
|
| Rate for Payer: BCN Commercial |
$535.43
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$649.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Healthscope Commercial |
$690.61
|
| Rate for Payer: Healthscope Whirlpool |
$669.89
|
| Rate for Payer: Mclaren Commercial |
$621.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.02
|
| Rate for Payer: Nomi Health Commercial |
$566.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$605.11
|
| Rate for Payer: Priority Health Narrow Network |
$484.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$607.74
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL 1
|
Facility
|
IP
|
$690.61
|
|
| Hospital Charge Code |
45000044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$448.90 |
| Max. Negotiated Rate |
$690.61 |
| Rate for Payer: Aetna Commercial |
$621.55
|
| Rate for Payer: ASR ASR |
$669.89
|
| Rate for Payer: ASR Commercial |
$669.89
|
| Rate for Payer: BCBS Trust/PPO |
$562.78
|
| Rate for Payer: BCN Commercial |
$535.43
|
| Rate for Payer: Cash Price |
$552.49
|
| Rate for Payer: Cofinity Commercial |
$649.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$552.49
|
| Rate for Payer: Healthscope Commercial |
$690.61
|
| Rate for Payer: Healthscope Whirlpool |
$669.89
|
| Rate for Payer: Mclaren Commercial |
$621.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.02
|
| Rate for Payer: Nomi Health Commercial |
$566.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$448.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$607.74
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
IP
|
$3,041.50
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,976.97 |
| Max. Negotiated Rate |
$3,041.50 |
| Rate for Payer: Aetna Commercial |
$2,737.35
|
| Rate for Payer: ASR ASR |
$2,950.26
|
| Rate for Payer: ASR Commercial |
$2,950.26
|
| Rate for Payer: BCBS Trust/PPO |
$2,478.52
|
| Rate for Payer: BCN Commercial |
$2,358.07
|
| Rate for Payer: Cash Price |
$2,433.20
|
| Rate for Payer: Cofinity Commercial |
$2,859.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,433.20
|
| Rate for Payer: Healthscope Commercial |
$3,041.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,950.26
|
| Rate for Payer: Mclaren Commercial |
$2,737.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,585.28
|
| Rate for Payer: Nomi Health Commercial |
$2,494.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,976.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,676.52
|
|
|
HC FRACTURE/DISLOCATION TX LEVEL II
|
Facility
|
OP
|
$3,041.50
|
|
| Hospital Charge Code |
45000104
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,216.60 |
| Max. Negotiated Rate |
$3,041.50 |
| Rate for Payer: Aetna Commercial |
$2,737.35
|
| Rate for Payer: Aetna Medicare |
$1,520.75
|
| Rate for Payer: ASR ASR |
$2,950.26
|
| Rate for Payer: ASR Commercial |
$2,950.26
|
| Rate for Payer: BCBS Complete |
$1,216.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,490.68
|
| Rate for Payer: BCN Commercial |
$2,358.07
|
| Rate for Payer: Cash Price |
$2,433.20
|
| Rate for Payer: Cofinity Commercial |
$2,859.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,433.20
|
| Rate for Payer: Healthscope Commercial |
$3,041.50
|
| Rate for Payer: Healthscope Whirlpool |
$2,950.26
|
| Rate for Payer: Mclaren Commercial |
$2,737.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,585.28
|
| Rate for Payer: Nomi Health Commercial |
$2,494.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,976.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,664.96
|
| Rate for Payer: Priority Health Narrow Network |
$2,132.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,676.52
|
|
|
HC FRAGILEX ANALYSIS
|
Facility
|
IP
|
$438.60
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$285.09 |
| Max. Negotiated Rate |
$438.60 |
| Rate for Payer: Aetna Commercial |
$394.74
|
| Rate for Payer: ASR ASR |
$425.44
|
| Rate for Payer: ASR Commercial |
$425.44
|
| Rate for Payer: BCBS Trust/PPO |
$357.42
|
| Rate for Payer: BCN Commercial |
$340.05
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$412.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Healthscope Commercial |
$438.60
|
| Rate for Payer: Healthscope Whirlpool |
$425.44
|
| Rate for Payer: Mclaren Commercial |
$394.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.97
|
|
|
HC FRAGILEX ANALYSIS
|
Facility
|
OP
|
$438.60
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.57 |
| Max. Negotiated Rate |
$438.60 |
| Rate for Payer: Aetna Commercial |
$394.74
|
| Rate for Payer: Aetna Medicare |
$57.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.30
|
| Rate for Payer: ASR ASR |
$425.44
|
| Rate for Payer: ASR Commercial |
$425.44
|
| Rate for Payer: BCBS Complete |
$32.10
|
| Rate for Payer: BCBS MAPPO |
$57.04
|
| Rate for Payer: BCBS Trust/PPO |
$359.17
|
| Rate for Payer: BCN Commercial |
$340.05
|
| Rate for Payer: BCN Medicare Advantage |
$57.04
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cash Price |
$350.88
|
| Rate for Payer: Cofinity Commercial |
$412.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.04
|
| Rate for Payer: Healthscope Commercial |
$438.60
|
| Rate for Payer: Healthscope Whirlpool |
$425.44
|
| Rate for Payer: Humana Choice PPO Medicare |
$57.04
|
| Rate for Payer: Mclaren Commercial |
$394.74
|
| Rate for Payer: Mclaren Medicaid |
$30.57
|
| Rate for Payer: Mclaren Medicare |
$57.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.89
|
| Rate for Payer: Meridian Medicaid |
$32.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.81
|
| Rate for Payer: Nomi Health Commercial |
$359.65
|
| Rate for Payer: PACE Medicare |
$54.19
|
| Rate for Payer: PACE SWMI |
$57.04
|
| Rate for Payer: PHP Commercial |
$62.74
|
| Rate for Payer: PHP Medicaid |
$30.57
|
| Rate for Payer: PHP Medicare Advantage |
$57.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.30
|
| Rate for Payer: Priority Health Medicare |
$57.04
|
| Rate for Payer: Priority Health Narrow Network |
$307.46
|
| Rate for Payer: Railroad Medicare Medicare |
$57.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$385.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.04
|
| Rate for Payer: UHC Exchange |
$88.41
|
| Rate for Payer: UHC Medicare Advantage |
$57.04
|
| Rate for Payer: UHCCP DNSP |
$57.04
|
| Rate for Payer: UHCCP Medicaid |
$30.57
|
| Rate for Payer: VA VA |
$57.04
|
|
|
HC FRAGILE X FOLLOW UP
|
Facility
|
IP
|
$257.04
|
|
|
Service Code
|
CPT 81244
|
| Hospital Charge Code |
30000113
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$167.08 |
| Max. Negotiated Rate |
$257.04 |
| Rate for Payer: Aetna Commercial |
$231.34
|
| Rate for Payer: ASR ASR |
$249.33
|
| Rate for Payer: ASR Commercial |
$249.33
|
| Rate for Payer: BCBS Trust/PPO |
$209.46
|
| Rate for Payer: BCN Commercial |
$199.28
|
| Rate for Payer: Cash Price |
$205.63
|
| Rate for Payer: Cofinity Commercial |
$241.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.63
|
| Rate for Payer: Healthscope Commercial |
$257.04
|
| Rate for Payer: Healthscope Whirlpool |
$249.33
|
| Rate for Payer: Mclaren Commercial |
$231.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.48
|
| Rate for Payer: Nomi Health Commercial |
$210.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$226.20
|
|
